Tuberculosis (TB) Case Study (60 min)
Included In This Lesson
Study Tools For Tuberculosis (TB) Case Study (60 min)
Outline
Mrs. Bull is a 39 year old female who presents to the Emergency Department (ED) complaining of a persistent cough for the last 3 months. In the last 3 days, she’s been experiencing chills and night sweats and today she noticed she was coughing up blood.
You suspect Mrs. Bull may have tuberculosis. What other personal and/or medical history questions do you need to ask to be sure?
What nursing assessments should be performed at this time for Mrs. Bull?
You assessment findings include rhonchi in the right upper lobe of Mrs. Bull’s lungs, normal S1 and S2 heart sounds heard, active bowel sounds, and 2+ peripheral pulses x 4 extremities. Her skin appears clammy and somewhat pale. Upon further questioning, Mrs. Bull reports recent travel to South America. She denies knowingly having a fever, but acknowledges she has been more fatigued lately and reports a recent unintentional weight loss of 20 lbs in the last 2 months. Vital signs are as follows:
BP 146/78 mmHg HR 92 bpm
RR 24 bpm Temp 101.2°F
SpO2 90% on room air
What nursing action(s) should be taken at this time?
What diagnostic tests would you anticipate the provider ordering?
The ED Provider orders the following:
Chest X-Ray, Sputum Culture with AFB Smear, Blood Cultures x 2, Place PPD tuberculin skin test, Keep SpO2 > 92%, Administer the following medications:
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Rifampin 600 mg PO daily
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Isoniazide 300 mg PO daily
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Pyrazinamide 1500 mg PO daily
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Ethambutol 1200 mg PO daily
Which order should you implement first? Second? Why?
What education should you provide to Mrs. Bull and her family at this time?
Mrs. Bull’s sputum cultures reveal she is, indeed, positive for Mycobacterium tuberculosis. Her PPD skin test reveals a 17 mm induration on her left arm after 48 hours. She is admitted to a general medical-surgical floor into a negative pressure room. She has now completed 3 weeks of RIPE therapy, which she tolerated well, and she no longer has a cough or other symptoms. Since she is no longer considered contagious, the doctor has ordered for her to be discharged home to continue the rest of her medication course.
What discharge teaching will be required for Mrs. Bull?
Explain why medication compliance is so important for Mrs. Bull.
review all the things
Concepts Covered:
- Cardiovascular
- Emergency Care of the Cardiac Patient
- Cardiac Disorders
- Shock
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of Pancreas
- Disorders of the Thyroid & Parathyroid Glands
- Hematology
- Gastrointestinal
- Upper GI Disorders
- Newborn Complications
- Liver & Gallbladder Disorders
- Lower GI Disorders
- Multisystem
- Neurological
- Central Nervous System Disorders – Brain
- Renal
- Respiratory
- Urinary System
- Respiratory System
- Noninfectious Respiratory Disorder
- Test Taking Strategies
- Medication Administration
- Respiratory Disorders
- Pregnancy Risks
- Labor Complications
- Fundamentals of Emergency Nursing
- Factors Influencing Community Health
- EENT Disorders
- Basics of Chemistry
- Adult
- Emergency Care of the Neurological Patient
- Acute & Chronic Renal Disorders
- Emergency Care of the Respiratory Patient
- Respiratory Emergencies
- Studying
- Substance Abuse Disorders
- Disorders of the Adrenal Gland
- Behavior
- Documentation and Communication
- Preoperative Nursing
- Endocrine System
- Legal and Ethical Issues
- Basics of NCLEX
- Communication
- Understanding Society
- Immunological Disorders
- Cognitive Disorders
- Musculoskeletal Trauma
- Intraoperative Nursing
- Eating Disorders
- Prenatal Concepts
- Anxiety Disorders
- Depressive Disorders
- Oncology Disorders
- Personality Disorders
- Psychotic Disorders
- Trauma-Stress Disorders
- Gastrointestinal Disorders
- Circulatory System
- Integumentary Disorders
- Neurologic and Cognitive Disorders
- Nervous System
- Microbiology
- Hematologic Disorders
- Emergency Care of the Trauma Patient
- Newborn Care
- Digestive System
- Urinary Disorders
- Postpartum Care
- Infectious Respiratory Disorder
- Integumentary Disorders
- Terminology
- Concepts of Population Health
- Musculoskeletal Disorders
- EENT Disorders
- Postpartum Complications
- Postoperative Nursing
- Neurological Emergencies
- Vascular Disorders
- Disorders of Thermoregulation
- Statistics
- Neurological Trauma
- Cardiovascular Disorders
- Basic
- Concepts of Mental Health
- Health & Stress
- Endocrine and Metabolic Disorders
- Delegation
- Perioperative Nursing Roles
- Developmental Considerations
- Childhood Growth and Development
- Prenatal and Neonatal Growth and Development
- Renal Disorders
- Concepts of Pharmacology
- Integumentary Important Points
- Fetal Development
- Renal and Urinary Disorders
- Community Health Overview
- Developmental Theories
- Labor and Delivery
- Infectious Disease Disorders
- Musculoskeletal Disorders
- Basics of Human Biology
- Psychological Emergencies
- Adulthood Growth and Development
- Growth & Development
- Female Reproductive Disorders
- Sexually Transmitted Infections
- Proteins
- Hematologic Disorders
- Tissues and Glands
- Somatoform Disorders
- Oncologic Disorders
- Skeletal System
- Basics of Sociology
- Bipolar Disorders
- Emotions and Motivation
- Peripheral Nervous System Disorders
- Central Nervous System Disorders – Spinal Cord
- Neonatal
- Male Reproductive Disorders
- Prioritization
- Pediatric
- Psychological Disorders
- State of Consciousness
- Sensory System